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First published online March 30, 2010

Differences in Perceptions of the Diagnosis and Treatment of Obstructive Sleep Apnea and Continuous Positive Airway Pressure Therapy Among Adherers and Nonadherers

Abstract

Obstructive sleep apnea (OSA) patients’ consistent use of continuous positive airway pressure (CPAP) therapy is critical to realizing improved functional outcomes and reducing untoward health risks associated with OSA. We conducted a mixed methods, concurrent, nested study to explore OSA patients’ beliefs and perceptions of the diagnosis and CPAP treatment that differentiate adherent from nonadherent patients prior to and after the first week of treatment, when the pattern of CPAP use is established. Guided by social cognitive theory, themes were derived from 30 interviews conducted postdiagnosis and after 1 week of CPAP use. Directed content analysis, followed by categorization of participants as adherent/nonadherent from objectively measured CPAP use, preceded across-case analysis among 15 participants with severe OSA. Beliefs and perceptions that differed between adherers and nonadherers included OSA risk perception, symptom recognition, self-efficacy, outcome expectations, treatment goals, and treatment facilitators/ barriers. Our findings suggest opportunities for developing and testing tailored interventions to promote CPAP use.

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Article first published online: March 30, 2010
Issue published: July 2010

Keywords

  1. adherence
  2. compliance
  3. content analysis
  4. decision making
  5. health behavior
  6. mixed methods
  7. sleep disorders
  8. social cognitive theory

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History

Published online: March 30, 2010
Issue published: July 2010
PubMed: 20354236

Authors

Affiliations

Amy M. Sawyer
University of Pennsylvania, Philadelphia, Pennsylvania, USA, [email protected]
Janet A. Deatrick
University of Pennsylvania, Philadelphia, Pennsylvania, USA
Samuel T. Kuna
Philadelphia Veterans Affairs Medical Center, Philadelphia, Pennsylvania, USA
Terri E. Weaver
University of Pennsylvania, Philadelphia, Pennsylvania, USA

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